SHM Converge Scientific Abstract ePoster Gallery-Using Hospitalist Consults to Provide Safer Care for Ed Boarders

Pdf Summary

The Washington DC VA Medical Center faced prolonged emergency department (ED) boarding, with admit delays often ranging from 200 to 250 minutes, well above the goal of 90 minutes. ED boarding is associated with worse outcomes, including safety events, longer hospital stays, and higher mortality. Because creating a separate boarding unit would require substantial staffing and resources, the hospitalist group developed a consult service to support boarded ED patients.<br /><br />The intervention provided hospitalist consults for ED boarders during regular business hours, prioritizing complex cases, questions about level of care, and patients needing careful triage. The consult hospitalist collaborated with the flow center to identify available beds, documented recommendations in a note, and worked alongside ED attending physicians, who remained responsible for placing and executing orders. The model emphasized collaboration between hospitalists and ED clinicians.<br /><br />The aim was to reduce admit delay to under 200 minutes within one year and to monitor patient safety events related to admission. While the summary does not provide numerical outcome data, reported benefits included improved subspecialist engagement, better triage decisions, and safer medication administration. Inpatient hospitalists also valued earlier consultation and documentation, which helped start appropriate care sooner.<br /><br />Key lessons were that consult-based support can improve care for ED boarders without requiring major new resources, but boarding and patient flow problems require a multidisciplinary effort. Hospitalist consult services can be a useful part of the solution, yet meaningful improvement depends on engagement from the ED, inpatient teams, and hospital leadership.

Asset Subtitle

Jessica Logan

Meta Tag

Author List Cherinne Arundel, Jessica Logan

Category Innovations

Concept Emergency Department Boarding

Concept Patient Safety

Concept Patient Flow

Concept Hospitalist Consult Service

Concept Project Aim

Distinguished Non-Finalist

Presenter Organization Washington DC VA Medical Center

Presenting Author Jessica Logan

Track Transitions of Care

Keywords

Washington DC VA Medical Center

emergency department boarding

admit delays

hospitalist consult service

ED boarders

patient flow

triage

bed placement

patient safety

multidisciplinary care

Emergency Department Boarding

Patient Safety

Patient Flow

Hospitalist Consult Service

Project Aim